<FormResults Date="4/13/2005 2:53 PM">
	<FormName>Sample Form</FormName>
	<AdminMessage/>
	<Field>
		<Question>Full Name</Question>
		<Answers>
			<Answer>John Smith</Answer>
		</Answers>
	</Field>
	<Field>
		<Question>State</Question>
		<Answers>
			<Answer>California</Answer>
		</Answers>
	</Field>
	<Field>
		<Question>Email Address</Question>
		<Answers>
			<Answer>j.smith@xyz.com</Answer>
		</Answers>
	</Field>
	<Field>
		<Question>Zip Code</Question>
		<Answers>
			<Answer>94015</Answer>
		</Answers>
	</Field>
	<Field>
		<Question>Birth Date</Question>
		<Answers>
			<Answer>12/19/60</Answer>
		</Answers>
	</Field>
	<Field>
		<Question>Send more information</Question>
		<Answers>
			<Answer>Yes</Answer>
		</Answers>
	</Field>
	<Field>
		<Question>Residency Status</Question>
		<Answers>
			<Answer>Legal Resident</Answer>
		</Answers>
	</Field>
	<Field>
		<Question>Areas of Interest</Question>
		<Answers>
			<Answer/>
		</Answers>
	</Field>
	<Field>
		<Question>I read these publications</Question>
		<Answers>
			<Answer>House &amp; Garden</Answer>
		</Answers>
	</Field>
	<Field>
		<Question>Comments</Question>
		<Answers>
			<Answer>Form Master by Code 5 Systems, LLC</Answer>
		</Answers>
	</Field>
</FormResults>
